Application Form for Integrative Health Coach Training

Application instructions for SELF-PACED INTEGRATIVE HEALTH COACH TRAINING PROGRAM

Before completing this application, please download the INFORMATION KIT.
Applicants will be notified via email within 48 hours and may possibly be asked to attend a brief telephone interview with Dr. Nickerson.
Any information you share via this website is private. For more information, please read our full privacy policy.
By submitting this application, you are under NO obligation to enroll in the program.

Which program are you interested in taking? I am interested in the Self-Paced Integrative Health Coach Training Program I am also interested in the Highly Sensitive Person Certification TrainingI am also interested in the Optimum Brain Health CourseI am also interested in the Corporate Integrative Health Coach Training ProgramLegal NameStreet Address CityState/Province, Zip/Postal CodePhone Number (where you prefer to be contacted, if needed)Email AddressBirthdate Education (please include your field of study)Previous Experience (list only those roles that are relevant to your participating in the Integrative Health Coach Training Program)Medical Conditions (optional)Tell us about your interest in mind-body-spirit health and wellness. What life events transpired to bring you here?How would you like to apply your health coach training in your professional life? (working in a health organization, private practice, supplement your current position)Are you currently working? If so, in what profession?How do you best like to learn? (Visual, auditory, reading? Group discussions or individual?)How did you hear about this course?If approved, what date do you intend to start the course?Today's Date

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Application Form

for Integrative Health Coach Training Program

Application instructions for SELF-PACED INTEGRATIVE HEALTH COACH TRAINING PROGRAM